Utilization Management Coordinator (Hybrid) at Three Point Solutions Inc
Baltimore, MD
About the Job
Job Title: Utilization Management Coordinator I
Client: Healthcare Insurance Company
Duration: 12-Month Contract
Location: Baltimore, MD 21224 (Hybrid)
Job Description:
Purpose:
Supports Utilization Management clinical teams by handling non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care.
Essential Functions:
35%: Member or provider-related administrative support, including benefit verification, authorization management, claims inquiries, and case documentation.
35%: Reviews authorization requests for initial determination or triages for clinical review.
20%: General support and coordination, including answering calls, taking messages, writing letters, researching, and solving problems.
10%: Assists with reporting, data tracking, and dissemination of information, such as Continuity of Care processes and Peer to Peer reviews.
Qualifications:
High School Diploma.
3 years' experience in healthcare claims/service areas or office support.
Preferred Qualifications:
2 years' experience in healthcare/managed care or previous division work experience.
Knowledge of CPT and ICD-10 coding.
Knowledge, Skills, and Abilities (KSAs):
Effective participation in multi-disciplinary teams.
Excellent communication, organizational, and customer service skills.
Knowledge of medical terminology and managed care concepts.
Proficient in evaluating medical support operations business practices.
Strong independent judgment and decision-making skills.
Attention to detail and proficiency with web-based technology and Microsoft Office.
Ability to work in fast-paced environments with changing priorities.
Positive customer service, even with demanding customers.
Top 5 Required Skills:
Medical background
Computer skills
Medical terminology
Claims and service office support
CPT and ICD-10 coding
#ZR
Client: Healthcare Insurance Company
Duration: 12-Month Contract
Location: Baltimore, MD 21224 (Hybrid)
Job Description:
Purpose:
Supports Utilization Management clinical teams by handling non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care.
Essential Functions:
35%: Member or provider-related administrative support, including benefit verification, authorization management, claims inquiries, and case documentation.
35%: Reviews authorization requests for initial determination or triages for clinical review.
20%: General support and coordination, including answering calls, taking messages, writing letters, researching, and solving problems.
10%: Assists with reporting, data tracking, and dissemination of information, such as Continuity of Care processes and Peer to Peer reviews.
Qualifications:
High School Diploma.
3 years' experience in healthcare claims/service areas or office support.
Preferred Qualifications:
2 years' experience in healthcare/managed care or previous division work experience.
Knowledge of CPT and ICD-10 coding.
Knowledge, Skills, and Abilities (KSAs):
Effective participation in multi-disciplinary teams.
Excellent communication, organizational, and customer service skills.
Knowledge of medical terminology and managed care concepts.
Proficient in evaluating medical support operations business practices.
Strong independent judgment and decision-making skills.
Attention to detail and proficiency with web-based technology and Microsoft Office.
Ability to work in fast-paced environments with changing priorities.
Positive customer service, even with demanding customers.
Top 5 Required Skills:
Medical background
Computer skills
Medical terminology
Claims and service office support
CPT and ICD-10 coding
#ZR